Provider Demographics
NPI:1104254424
Name:LODER, CHRISTINA (LCMHC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:LODER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-1958
Mailing Address - Country:US
Mailing Address - Phone:039-313-9146
Mailing Address - Fax:603-232-4954
Practice Address - Street 1:1056 RIVER RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-1958
Practice Address - Country:US
Practice Address - Phone:603-931-3914
Practice Address - Fax:603-232-4954
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NH2061101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor